Key takeaways
Phenytoin (Dilantin) and lamotrigine (Lamictal) are both antiepileptic medications used to treat seizures, but they have some key differences. Phenytoin is specifically used for tonic-clonic and psychomotor seizures, as well as seizures related to brain surgery. Lamotrigine, on the other hand, can treat partial and tonic-clonic seizures, seizures of Lennox-Gastaut syndrome, and bipolar disorder. Phenytoin requires regular blood tests to monitor levels and has a risk of serious side effects like liver damage and severe allergic reactions, especially in people of Asian ancestry with the HLA-B*1502 gene. Lamotrigine also has serious risks, including severe skin reactions and meningitis. Its dose must be increased slowly to avoid the risk of serious rash. Both medications interact with many other drugs, including prescribed and over-the-counter medications. Phenytoin is available in capsules, chewable tablets, liquid, and injection, while lamotrigine in chewable and quick-dissolving tablets, as well as extended-release tablets.
